Ortho Flashcards
What are we worried about in fractures
Neurovasucalr comprimise
Name carpal bones
Some lover try positions that they can’t handle
Scaphoid
Lunate
Triquetrium
Pisiform
Trapezium
Trapezoid
Capitate
Hook of hamate
What are we actually looking for in x rays
1?bones
2. Joints
3.soft tissue
Describe densities and conditions
Low density _ would appear more lucent [black)- osteopenia /porosis
High density _ appear more opaque = osteoscleoris
Definitive dx osteopeeosis
dexa scan
MM pneumonic
CRAB
1.hypercalcemia
2.anemia
3. Renal dysfunction
4. Bone lesions ~ pain
signs of a femoral fracture
external rotation
shortened leg
inability to weigh bear
complications of a nof
DVT
PE
NONUNION
AVASCULAR NECROSIS
DX OF NOF
diagnosis
could be an intertrochanteric fracture
hip dislocation - also pain
- pelvic fracture
hip x ray
management of NOF
- Primarlily surgical
what is fascia iliaca block
CI
a type of regional aneatehsia (numbs from hip down )
allergy to any of the anesthetics used
bleeding diatheiss
signs of infection around the site or a wound
relative, on aticoagulations
complications of a fascia iliaca block
- Hit femoral arteyr
- hypotension (anetheisa)
- bradycarida
- anaphylaxis
- damage the nerve directly
- simply inadeuqate anesthesia either wrong place or not enough given
the one you really dont want is toxicity caused by injection directly into the vessels causing cardiac arrest or arrythmia
thats why its better to use ultrasound to mitgate
whats imperivate with facsia iliac a
to be constantly monitoring the patient for any side effects
femoral block vs fascia iliaca
Both used for the same effect
blocks more nerves like obturator, femoral and lateral cutaneous
FNB-injects around the femoral nerve so increased risk of neuropraxia
FIB- injects under fascia iliaca which surrounds the femorala nerve
what are the pops you hear in a fascia iliac block
- popped the lata
- popped the iliaca
proceudre of fascia iliaca
draw a line between ASIS AND PUBIC SYMPHISIS
DIVIDE INTO THIRDS
…..
INJECT LOCAL ANESTHETSIC TO FORM A LITTLE SKIN WHEARL
GO IN WITH BIG NEEDLE HEAR THE POPS PULL BACK BEFORE YOU INJECT TO MAKE SURE NO BLOOD
the whole point is to stay away from the femoral vessles, you inject into the space lateral to them so that the drug pools out and spreads out towards the nerves
femoreal nerve function
senory nerve anterior thigh
motor function of thigh
what is the iliacus muscle and why is it relevant to nerve blocak
the fasical iliac which is the deepest facial plane lies directly on top of it so when you do the block its going around the muscle
